Endocrine Flashcards
Most common cause of cushings?
pituitary adenoma (AKA cushings disease) - secretes ACTH causing adrenal hyperplasia which produces excess cortisol
which type of cancer can cause cushings via paraneoplastic ACTH production?
small cell lung cancer
what paraneoplastic hormone does squamous cell carcinoma (lung) secrete?
PTH - leads to hypercalcaemia
5 ACTH independent causes of cushings?
steroid use
adrenal adenoma
adrenal carcinoma
micronodular adrenal dysplasia
carney complex (syndrome including cardiac myxoma)
main symptoms of cushings?
central obesity
buffalo hump
hypertension
hyperglycaemia
muscle/bone/skin breakdown (skinny legs, osteoporosis, dry fragile skin and hair loss)
disturbs ovarian/testicular function
more susceptible to infection
how is cushings diagnosed?
dexamethasone suppression test - small dose dexamethasone given PM and 9am cortisol level checked next day (should be low, positive if cortisol remains high or unchanged)
can check values for 24hr urinary cortisol or serum ACTH levels
imaging
management of cushings
gradually withdraw steroid use (if responsible)
may need surgical excission of tumour
adrenal steroid inhibitors (ketoconazole or metyrapone)
What type of drug is Gliclazide?
Sulphonylurea
Side effects of sulphonylureas?
weight gain
hypoglycaemia
which diabetes drugs are unsafe in pregnancy?
Sulphonylureas (gliclazide)
SGLT2 inhibitors (flozins)
GLP1 agonists
DPP4 inhibitors
What are some examples of SGLT2 inhibitors?
end in flozin
Which drugs are GLP1 agonists?
end in tide
Which drugs are DPP4 inhibitors?
end in gliptin
